Shin splints (MTSS) can be prevented with the right approach — and preventing them is much easier than fixing them once they start. We know that shin splints occur when there is a mismatch between load and recovery time, leading to pain along the border of the tibia. In the military, with relentless demands and very little rest, this mismatch is easy to create.

Wherever you look, you will find different solutions ranging from the logical to the absurd. Here is a full evidence-based review of MTSS prevention strategies so you can take the guesswork out of the process.

WHAT THE EVIDENCE SAYS

The table below shows the most common prevention strategies and whether the evidence actually supports them:

Strategy Evidence Application
Gradual Load Progression✅ Strong≤10% weekly increases; structured periodisation
Strength & Conditioning✅ StrongCalf, glute med, soleus — weekly strength and conditioning with single-leg control
Gait Retraining✅ Moderate–StrongCadence increase, midfoot strike — reduce vertical load rates
Experience-Based Programming✅ StrongTiered training levels; baseline fitness screening
Vitamin D & Bone Health✅ Strong (stress fractures)Screen for deficiency; supplement as needed
Surface Management✅ ModerateGrass and trails early; progress to firm ground gradually
Footwear & Orthotics⚠️ MixedAfter individual screening only — avoid universal prescription
Flexibility & Mobility⚠️ ModerateOnly when tightness is evident; combine with strength work
Compression / Wearables❌ WeakNot recommended for prevention
Stretching Alone❌ WeakDo not rely on passive stretching alone
The Five Most Effective Strategies
  • Gradual load progression
  • Strength and conditioning
  • Experience-based programming
  • Gait retraining
  • Vitamin D and bone health

BREAKING DOWN THE KEY STRATEGIES

Gradual Load Progression

This is where most soldiers and recruits go wrong. They either undertrain or overtrain in the build-up to a course or to deployment and find themselves flaring up early on. Gradual load progression means planning your training increases systematically — a maximum of 10% increase in weekly volume at a time. An informed, structured approach to programming is the solution to avoid the sharp spikes in load that cause MTSS.

Strength and Conditioning

Building adequate strength and endurance in the key muscle groups is essential. Weakness in the calf, tibialis posterior, peroneals and glute medius creates overload through the shin during running and load carriage. A complete and targeted strength and conditioning plan is essential — both for shock absorption and for building progressively stronger muscles and bones that can tolerate military demands.

Experience-Based Programming

This means training at your level. In the military it is easy to compare yourself to those around you — their fitness, their gym experience, their training history. But starting your programme at the right level for you and progressing through the phases at the right pace is what keeps your shins pain-free as they adapt. Ego-driven progression is one of the fastest routes to injury.

Gait Retraining

Efficient running and tabbing technique is essential for distributing forces optimally through the leg. Getting this right early saves a significant amount of stress later — it is much easier to learn to run properly from the start than to relearn it years down the line. Counting your cadence while running or using a smartwatch to monitor stride frequency are practical tools to check how forces are being distributed during running.

Vitamin D and Bone Health

Strong evidence links reduced vitamin D and calcium with increased rates of bone stress injuries — particularly stress fractures. Low vitamin D affects how calcium is absorbed and utilised, which can lead to weakened bones and stress reactions under load. A healthy diet, appropriate supplementation where deficiency is identified, and monitoring are all relevant here — particularly for female athletes and those at risk of RED-S (Relative Energy Deficiency in Sport), a condition where calorie intake fails to meet the demands of training, leading to hormonal, bone and performance consequences.

WHAT GOOD PREVENTION LOOKS LIKE

Effective MTSS prevention plans for military personnel should:

The PREP Shin Splints Plan was designed specifically for military personnel — soldiers, recruits and aspiring recruits — to take the guesswork out of prevention and recovery. It incorporates all of the evidence-based principles above in a structured, progressive 12-week protocol.

Written By
Sam
Masters in Physiotherapy  ·  HCPC Registered  ·  Specialist MSK Physiotherapist
Shin Splints Plan
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